| NPI | 1487714705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 659-125) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 11514) |
| 101Y00000X Counselor (Licence: WI 228871) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2015-05-15 |